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I will start out by saying that I wish I could give Dr Spiro and his entire team including Mikayla, Jess, Kelly, Christina, Marlene and Erika a 10 star review. From my first meeting with Dr Spiro and Christina I felt like they listened to me intently and explained what my options were after examining me. I knew I was in the best hands from that moment. Dr Spiro is an excellent surgeon which is first and foremost to me. He is precise, methodical, a great listener, patient, flexible, professional and best of all ….an artist. I have researched and interviewed surgeons for 7 years trying to choose the best one after having had a horrible outcome from a prior breast augmentation that was performed by another surgeon. Dr Spiro was the only surgeon that discovered I had capsular contractions in my breast from my implant while all the other surgeons I interviewed never recognized it. Dr. Spiro also told me that I would only feel some pain for the first 4 days after my tummy tuck which pleasantly surprised me during our meeting although I must confess I highly doubted. I thought it would be unbearable but it was just as he described. I did not need any heavy narcotics just a little Tylenol and Valium and I was good. By Day 4 , I felt great !! By day 7 I did not even need to take one Tylenol!! This is how you know you made the right choice from a medical perspective. Aesthetically he promised I would come to my first post op visit and be so happy with my results and I was!!!! My breasts are absolutely gorgeous!! I was in shock because they were an absolute disaster before the surgery to the point that every time I went for a Mamo I was told to go see Dr Spiro to get my implants redone. Glad I listened!! Before Spiro, my breast implants would move when I would work out. They actually moved outside of my sports bra into my armpit. I looked like a circus act. I had animation deformity which is extremely difficult to correct not to re-mention the capsular contraction. Now let’s talk tummy. He tightened my skin perfectly so that it is taut but doesn’t look stretched. My skin looks so youthful now which before the surgery it looked sun damaged, stretched and wrinkled. He got rid of my Fupa (puboplasty), my love handles (flankoplasty), my distended belly which made me look like I was still pregnant (diastsis repair) and he liposuctioned my hips which I thought I didn’t need bc I am petite but I listened to him and am so happy I did because it created such a curvy shape in my waist and made my natural butt look incredible. He repaired two hernias of which one was discovered during surgery and was severe and the other was an umbilical hernia. He created a new belly button which is extremely tricky in a tummy tuck. Most surgeons fail at this step so I was so nervous. I showed him exactly how I wanted my belly button to look and he created the most natural, beautiful belly button ( nicer than the one I was born with). He sculpted my body into the shape of a youthful, sexy, classy woman. So feminine and beautiful. My advice is like a Nike ad. Just do it!
Dr.Spiro , is absolutely Brilliant from the detailed consultation to the flawless outcome of my breast reduction , breast lift augmentation “surgery” Dr.Spiro from the moment he meets you is formulating and thinking outside the box to create the amazing outcome . He is super detailed to all body types ! Dr.Spiro has achieved on me what I thought was unachievable in the past . The entire surgery was like I did not even have anything’s done . I felt super well ! This doctor is truly a MASTER ! I am truly grateful he truly is a true artist and all magical . Forever grateful
Dr Spiro is absolutely amazing and by far one of the warmest and most professional doctor I have ever met. He did my breast reduction with such artistry and care. My expectations were surpassed by 100x. Never in a million years would I have expected to have breasts that were so perfect. The day after my surgery when he removed my bandage I cried tears of happiness. I was in absolute awe. His staff was so kind and sweet and you can see how happy they all were to see how happy I was. They were all very genuine. Thank you Dr Spiro for changing my life. It’s been a long time since I felt happy in my skin. I’m enjoying shopping for all the cute bras, bikinis and tops I was never able to wear before. Thank you again Dr Spiro for giving me my confidence back. I will never forget what you did you me!
OKAY LONG POST ALERT! Sorry! I am officially 1 Month Post Op- Skin Only Abdominoplasty- liposuction of the flanks with minimal fat transfer to the buttox- 800 CC Silicone Implants under the muscle with Mastopexy- I am 5'8 167/170 pound, 25 year old female who has never had kids. After losing over 140 pounds naturally with diet/exercise over the course of 3 years, I decided I wanted to get my loose skin removed (there was a fair amount on my abdomen and breasts that I was still quite self-conscious of and I wanted to see the results I had worked so hard for.) I did not know my options as to what a doctor would be able to do for me because I had not had any previous experience with plastic surgery. My mother and I (or sometimes my sister- who is a nurse- and I) saw over 10 doctors within the tri- state area/Manhattan, as well as a doctor in Florida ( where I'm from) to try and find someone who would be honest with me as to what my situation is, and what my options were. I was looking for a doctor who wouldn't just tell me what I wanted to hear, but would be honest with me regarding the actuality of my situation and circumstance. If you are reading this and might in a similar position as what I went through, take it from a person who has been to many consultations throughout the course of over a year and save yourself the money/time. Get yourself set up with a consultation with Dr. Spiro to experience it for yourself. He and his staff will explain to you in every detail and nuance what your options are, and what would be best for you- regardless of ANYTHING else. It was a total breath of fresh air to have this type of professionalism and comfort in an industry I was already quite skeptical of. The level of expertise that will be provided to you is unmatched. Every single detail even months after your surgery regarding your scar care and any possible minuscule side effect will be totally looked after. The nurses and his staff as a whole could not be any more attentive to details or helpful to you during pre-op AND post-op. (Which I have realized is extremely rare to CONTINUE getting as much attentive assistance with your ENTIRE process of healing) The level of professionalism, thoroughness, and reliability you will receive from this office will be unmatched in comparison to somewhere else. I know from multiple different consultation experiences and my overall outcome of my procedure. Now to discuss the results/ outcome of my surgery. I cant even put into words the level of comfort and freedom I feel in my body already. I would not be able to describe the type of happiness that I had already felt from my entire weight loss journey and then to have had a surgery that just enhanced everything I've worked for in the most natural, subtle, and amplified way. I am one month post op and feel 100% sure and so happy with every decision I have made regarding this procedure and could not be more grateful and appreciative that I found this office and surgeon. I believe it ended up being maybe over 20 inches of loose skin on my abdomen in total? I am supposed to see even better results within the next few weeks with my breasts settling even more into place and starting all my scar treatments. When I will be able to start working out again fully will be within the next few weeks too, and that should enhance my figure even more they told me. (right now just doing moderate walking) WHICH IS HARD TO BELIEVE IT COULD GET BETTER I've attached my before and after photos taken before surgery one showing the deflation/loose skin of my breasts/ abdomen and the other showing the loose skin on my abdomen- and then 3 weeks post op. I will update on my scar and overall healing as soon as I begin scar treatments, silicone gel/sheets. Dreams do come true, and everyone deserves to feel beautiful, secure, and at peace in their own skin. If you are going to have surgery you might as well make sure its done right. Thank you Dr. Spiro and staff for everything!!
Dr. Spiro is an artist and my experience with him has been nothing short of spectacular. I had an unusual type of tummy tuck /abdominoplasty with him -- I don't know anyone else who has done it the way I have, but I cannot overestimate how thrilled I am with the results. He basically did the resection first (in other words, he did the tummy tuck first) and then created a brand new belly button afterwards. (Neoumbilicoplasty.) The cons are that you have to have the stomach (pun intended) to live without a belly button for a few months. The pros are that you end up with no scar around the belly button because the sutures are embedded inside the bellybutton rather than done the "traditional" way of using your original bellybutton opening. Even though I am still healing (and have some irritation on the stomach from my bandages), I can already tell that my tummy tuck scar looks awesome and that I will have the most gorgeous and elegant bellybutton. I frankly can't wait to hit the beach in a bikini -- I feel like I'll be ready in a few months. By the way, I'm 50 with 2 children and I -- no joke -- feel like I now have the body of a 20 year old. Thank you, Dr. Spiro! And thanks too to your amazing staff who has been patient and lovely!
I have had an amazing experience with Dr. Spiro. My questions, concerns and fears were met with patience, compassion, professionalism and confidence to create the comfort level I needed to trust Dr. Spiro and his staff implicitly. Dr. Spiro is a meticulous surgeon and talented artist who produced amazing, natural looking results for me. It's rare to find a doctor and an office that is so sensitive to addressing all the emotional components that go hand in hand with the medical treatment of a patient. I am so grateful to be in his care.
Everything about my experience with Dr. Spiro and his staff was 5 Star. From the initial consultation through the follow up apts post op, I was treated with care and respect and felt well informed about the procedure. I could't be happier with the results of my procedures and would highly recommend Dr. Spiro to anyone undergoing the same surgery. The billing and handling of insurance was handled directly by Dr. Spiro's staff and was practically a non-event for me and completely eliminated any additional stress and worry.
Are there only 5 stars? That’s not enough, Dr. Spiro is recognized for being the top in his field for a reason, he is the only Dr. I’d trust with not only my body but my life. I truly cannot put the love I have for this man in words. Forever grateful
It’s impossible to put into words how much I appreciate everything Dr. Spiro and his staffs have done for me. He is a truly gifted surgeon, a compassionate human being, and a consummate perfectionist. Everyone at the office was so supportive and professional I immediately felt comfortable, and I knew I had come to the right place. Never in my wildest dreams did I think I could look like this again. About 13 years ago I had sinus cancer which was successfully treated with radiation. Unfortunately, over time, the area of my face that was treated became so gaunt that I looked like a heroin addict. Using photos of me taken just before the cancer as a guide, Dr. Spiro spent 6 hours reshaping my face and grafting fat into the affected areas. I prepared myself for a long painful recovery and assumed it would be a while before I looked normal again. I was wrong on both counts!! When I woke up and saw myself for the first time I was amazed to find were no signs of bruising and I was already thrilled with the results. The nurses at the hospital were just terrific at managing the pain, and I was never really uncomfortable. In fact, it wasn’t till I had been home for several days that I was even aware of all the little incisions and stitching that had been done with such precision and hidden so well. It was a marvel poking around under my hair and discovering them all. The photos of me on his website speak for themselves and were taking exactly one month after the procedure. I can confidently say that having this surgery is the best decision I ever made. It took some courage to get myself to go through with it, but it has been a truly life changing experience and I will forever be grateful to Dr. Spiro and his staff.
I am 46 years old, had 2 children but never breastfed, 115 lbs & 5'3". I had a tummy tuck 7 years ago and am now ready for a breast lift. I was always nervous about putting implants into my body and although my breasts were small, I thought they looked fine. I was also afraid they would be hard and I liked the natural softness of my real breasts. I have done a lot of research and it is nice to know that it is one of the most performed surgeries with a 95% happiness rating. I also researched surgeons and went with one that I feel comfortable with and he does beautiful breast augmentation. PM me for info! I have always been 112 - 115 lbs. After my tummy tuck 7 years ago I slowly gained around 25 lbs. and had a hard time taking it off. Last year I finally started to take the weight off. After that I noticed my breasts were not the same. I liked being back to my happy weight, but they became saggy and very small. No cleavage! I also have one breast larger than the other. The areolas are also too big and look worse now that my breasts are smaller. My surgery is under 3 weeks away! Of course I'm nervous because I hope that they turn out nice - you never know! I felt the same before my tummy tuck, but it is the best thing I have done for myself, no regrets! So I am going to think positive and realistic. They have to end up looking better than what I have now, even with scars. I just hope my scars heal well and that the areola reduction will heal nicely. I am having a lift with silicone implants under the muscle and areola reduction. I will discuss the size with my surgeon when I see him next week for my pre-op appointment. He likes to choose the size based on body frame and proportion and I agree. I would of course like to go with the largest size proportionate for my frame. I will keep everyone posted on my recovery, pictures, etc. - I have been reading reviews every day and always loved Real Self for the reviews. It got me through my tummy tuck, I don't know what I would have done without it!! Updated on 4 Mar 2018: Just adding some before photos Updated on 11 Mar 2018: I am 11 days from surgery! I have been cooking a lot the past few weeks and freezing it so that I don't have to shop for and prepare meals. I made various soups full of veggies, breaded chicken to bake, quiche, pot pies. I can just pop them in the oven and have a homemade healthy dinner! I'm supposed to eat 80 to 100 grams of protein a day, so I am trying to make sure I have enough. I know myself, I will just eat junk if I am recovering, because I will be too tired to cook. I also bought lots of frozen fruits for smoothies and frozen veggies like kale, squash, beets, asparagus, etc. to roast, which is easy. Eating healthy helps healing! I had my pre op last week. I am going for Ultra High Profile 415/425 silicone implants. I am so excited!! Today I bought my neck pillow, ducolax and prunes. I swear the second I ate a prune after my tummy tuck, I went. Hopefully that shouldn't be a problem. I have enjoyed reading everyone's experiences and updates! It helps me to be ready with what to expect. Updated on 17 Mar 2018: I can't believe surgery is 5 days away! I'm very excited! I made some more soup today to freeze, bought all my frozen smoothie and frozen veggies to roast to ensure I eat healthy. I think I have everything I need. Yes I'm nervous, but also excited. Trying to stay positive. I'm starting to clean the house so that I'm not tempted to do it during recovery. I'm taking 4 days off from work, a desk job plus the weekend, so that's 6 days home to recover. I have added before photos of lingerie I would like to fill out more and will post after photos. Updated on 23 Mar 2018: The surgery went well, everyone was so nice and made me feel comfortable. I came home yesterday and ate lunch. I had no nausea. I am so glad I cooked and froze soups and dinners because if I didn't I would eat junk. I felt very sore since I returned and even though I took pain pills, I still feel soreness, but not too bad that I can't handle it. I am taking the pain pills for the next few days and will wean off them. I would say the hardest parts for me are not being able to pick things up or even open my medication bottles! I also have pressure on my chest and it is hard to take a deep breath, but I am trying. I was so dizzy and out of it all day yesterday. Today I'm feeling better and going to see my surgeon for a follow up. I didn't sleep too well last night because I am not a back sleeper. Today I get the dressings off and put into a bra. I can't wait to see what they look like. They look huge under the wrapping, I love it!! Updated on 24 Mar 2018: I had a good night sleep last night. I am still taking the pain pills. I was in pain early yesterday, but the pills helped and have been feeling good ever since. 2 things I noticed since my surgery: my vision is blurry, I can't even read a text message or book - I can see perfect a few feet in front of me, but it's just reading. I do have reading prescription glasses, but normally have no trouble reading without them and rarely use them. The other thing I was surprised about was my stomach is so bloated and rounded! I was 111 lbs morning of surgery and had muscle tone showing on my abs and have been eating very healthy. This morning I weigh 118 lbs! I realize the swelling and the implants add to that, so I won't worry about a number on the scale, but wow seeing all my hard ab work disappear stinks! I am also up and down a lot, which makes swelling worse. All a part of healing. Also no BM so that is contributing to my bloated tummy. I took a look at my boobs yesterday and I love them!! They are so big and the nipple/areola are nice and high and I have cleavage! I know they will change a lot in the next few months. We ended up with 455 cc Mentor Ultra High Profile implants. Saw my surgeon yesterday and everything looks great. I am out of my bandages and just wearing a bra. I love how he made my areolas smaller, they were so big before. I will add photos later today after I shower. Updated on 24 Mar 2018: I forgot to add that the reason I have blurred vision is the nausea patch that was behind my ear. Blurred vision is one of the most common side effects and it goes away in a few days. Updated on 25 Mar 2018: I have been sleeping very well, waking up very swollen. Everything looks great so far and although I can't see incisions under the tapes I can tell already that it will be a beautiful result. They are huge now, swelling, but I love it!! I have a check up on Tuesday. I think the tapes need to stay on for a total of 10 days. I have been eating very healthy and getting lots of rest. I feel light pain, last pain pill I took was last night. I have added photos and will keep updating. Updated on 26 Mar 2018: Today is 4 days after my surgery. Last night is the first night I did not take pain meds. I sleep very well. Wake up very swollen and sore, but it feels better as day goes on. No pain today. Showered, takes time because I have to Saran Wrap my boobs so tapes don't get wet. So far tapes are still on tight. See my surgeon tomorrow morning. Will find out if and when I massage. Soooo bloated, my tummy looks pregnant. Been eating great and healthy and resting. Got out today for a while but hurt my boobs to drive so resting now. Added pics, not much different than yesterday. Swollen everywhere. My eyesight is back I'm happy to say!! I am just so happy now because I can tell they will look so good after they heal. So curious to see the incision lines. Can't wait for the bloated tummy to go away, I have worked so hard at the gym it's hard to look at it now! And I feel like my back is curved and my butt flat. Ugh!! I know it's all temporary. Updated on 29 Mar 2018: I am 1 week post op today. Went back to work yesterday and today, glad to have tomorrow off, can rest up more this 3 day weekend. I have been still a bit sore, very swollen. I'm still in my tapes and compression bra. I get to take it off 2 hours twice a day and it feels so good. Tuesday the tapes come off, can't wait because it's hard to shower, can't get them wet and I just want to feel clean. I love the size and shape so far! I'm so excited to see them settle. Also really miss the gym, can't wait to get back to my routine but have to be patient. Most of the bruising is gone but I have some blisters that look gross, from the tapes. Updated on 31 Mar 2018: I know it's early but I just cannot express enough how happy I am that I did this. It was something I was thinking about for years, but felt hesitant to put implants into my body and I was worried they could come out botched. I am still swollen as ever, and have tons of healing to go, but when I put on tops and see the beautiful full, firm shape beneath them, I can't even tell you how good I feel about my body. Although I plan on wearing bras, it is so nice to occasionally go without one when going out and wearing a backless or off the shoulder top or dress. I love the curves and the cleavage! I work out consistently and eat healthy and I want my body to show that. I loved the rest of my body but my saggy small boobs just made me feel so old and did not match up to how I felt inside. I just felt the need to share my happiness! I went out with my girlfriend last night for dinner and a drink and I got dressed up and they just looked so good!!! Can't wait to see how they look when they are fully healed. Updated on 3 Apr 2018: I got my tapes removed today, so happy I can take a normal shower now. Everything still very swollen, incisions look great, love the size of my aerolas. Can't wait to keep healing. Still healing the blisters. Have to wear compression band for next 9 days until I see my surgeon again. It helps the shape. I'm very sore today for some reason, maybe having tapes removed and I think a few stitches came out. I will update with changes over the next few weeks. Updated on 6 Apr 2018: I'm just so happy! I love how they look, I feel so curvy and how I've always wanted to look! I think my surgeon did an amazing job, I love the size, shape, how he centered my nipples so symmetrically. I love how they look in clothing, I feel my waist finally looks so tiny. I love my new hourglass shape. The rounded top of my implants are going down slowly but I notice it, I know it's early so I'm not worried. It was 2 weeks yesterday since my surgery. I'm waking up swollen but feel better each day. I've been sleeping on my side comfortably for the past week. I put steristrips on my incisions because I noticed they were swelling and one part looked like it could start to spread, hopefully it helps. I feel energy and can't wait to get to the gym, slowly and carefully of course. Glad it's the weekend, I will rest. Next Friday I get to wear a regular bra!! Been a challenge dressing for work with the surgical bra, but can't complain, this surgery was not bad as far as pain, suffering, recovery. Updated on 6 Apr 2018: Before and after... Updated on 6 Apr 2018: Sorry forgot to add photos lol!! Updated on 9 Apr 2018: I have been feeling great lately, actually noticing swelling not so bad each day/ morning. No pain anymore. I have full feeling in my breasts, nipples, no numbness or sensitivity loss. My blisters are healing, scars covered in Steri strips. Starting to drop and get softer. I still wear my compression band, but the surgical bra does not fit right so I don't wear it. I'm getting fitted for new bras on Thursday, Friday i have a doctor visit and I will be allowed to wear regular bras!! I'm still loving the size, shape, so happy!! Love having curves :) Updated on 15 Apr 2018: I am now 3 & 1/2 weeks post op and feeling great! At my 3 week check up I got to finally ditch the surgical bra and compression band, thank god!! Now I am in regular bras. Feels and looks so good. I was measured at Nordstrom 30 DDDD. The bras fit perfectly. I only bought 2 for now and a sleep bra because I know the size will change in the next few. At VS I was measured 32 DDD for the sports bra. My surgeon checked the fit of all of these bras and said they were perfect fit. I have no pain now. Swelling started to really decrease at 3 weeks. I still swell, but it is not that painful feeling waking up that I had in the first few weeks. They are softening, dropping a bit. My blisters have all healed and now there is just redness where they were that is looking better each day. The scars also look good - I just keep steri strip tape on them for now because I am so afraid of them widening like my tummy tuck scar did. I had taken the tape off for a day and at night I noticed my scars puffing up and looking like they were starting to widen. I will keep the tape on for another week until I can start my scar treatment - surgeon said at 4 weeks post op. I love how I look in clothes, tank tops, etc. now. My waist looks really tiny now! I can't believe how much this boosted my body confidence. I work out, eat right and hated how my boobs looked before this. I now finally look how I feel and how I always wanted to look. I am cleared for the gym starting this week but can't work out arms until around 6 weeks. I plan to slowly go back to working out - tomorrow! I will post pics today or tomorrow. Updated on 15 Apr 2018: Here are a few pics - the scars look good and blisters are healed, just red skin now. Starting scar cream in a few days, at 4 weeks post op Updated on 24 Apr 2018: Wow, 5 weeks went fast! I feel amazing, back to the gym, slowly and carefully though. I can work out arms again after next week. I can move all different ways and no pain. Still haven't dropped, but left one looks a bit lower. I wear same sized bras, 30 DDDD as 2 weeks ago. I really can't complain. I love how big they are!! Love how my clothes are fitting. Really pleased with how well my scars are healing, still a light thin line, haven't stretched out. Still have red scars from the blisters, which is ugly, but they get lighter each week. Started silicone scar therapy last week. I feel the bras help with compression which helps heal the scars, keeps them flat. each week they get nicer! Updated on 12 May 2018: I can't believe it's been almost 2 months since my surgery. I feel amazing and no regrets. I love the size, shape of my breasts, how my clothes fit and how it makes my waist smaller. Have to admit I don't mind the stares lol!!! I love the cleavage, so glad I went larger, ultra high profile. I have to say the last week they really started softening up. They are so soft and squishy and actually bounce now! It really doesn't feel like implants when I squeeze them. Still using scar cream and they are red but I can tell they will fade very well. I'm loving the gym, now working arms and shoulders and each week I feel I can do a little more without pain. No chest exercises though. Updated on 7 Jun 2018: Can't believe it's 11 weeks, almost 3 months! Haven't posted in a while. Everything healing very well, I feel great and am very happy with how they look. Softening up nicely. Scars look better in real life than photos. Love how they look in toos, such beautiful cleavage!! Updated on 16 Jun 2018: I saw my surgeon yesterday and he said I am healing very well, that my scars look great and will fade so much I won't be able to see them!! I stopped using scar therapy because it was expensive and I went through it too quickly. Bought silicone sheets but they were a pain to use - just rubbing cocoa butter and bio oil on them twice a day and they are fading so nicely. I must say this past week has been the best so far with my boobs starting to look settled - I think they settled to how they are going to be, they are still so big which makes me happy because I was afraid the swelling would go down and they would be smaller than I wanted. They are soooo soft and bouncy and I love how they look in tops. They are starting to look more natural naked and I can't even imagine how they will look when the scars are completely faded. I bought some new bikini tops and can't wait to wear them. I will add photos soon. Updated on 25 Aug 2018: I can't believe I'm at 5 months post surgery. I have healed beautifully and am beyond thrilled with how they look. They are very soft and squishy now and just look amazing! I wouldn't change a thing! I love the size, shape, everything! No complications and so lucky I picked this surgeon for my breast lift. I am size 32 DDD or 30 DDDD. I love how they look in clothes and enjoyed wearing my bikinis on the beach this summer. I love having a curvy hourglass figure and it has been so nice occasionally wearing tops and dresses and not have to worry about a bra! The scars are fading nicely and are at the red stage but look much better than last month, I think month 4 was worst, they were thick, red and raised. I don't use any scar cream or silicone sheets, just palmers cocoa butter twice a day, and hand massage the scars a few minutes.
Iron deficiency anemia may limit the amount of surgery that can be done in one first stage. Typically there is little blood loss for any one procedure mentioned, but cumulatively it adds up. So it depends on the magnitude of the anemia. We have a hematologist involved in these situations and pre treat and post treat patients with iron infusions and oral iron to optimize them for surgery. You mention a "mini" tt for muscle repair but if you read the many things I have written on this subject, anything involving muscle repair or abdominal wall is not mini. mini tt is classically defined as infra umbilical skin only tt. Complete skin only is another type, then we go into tt involving abdominal wall work which may or may not include transposition of the belly button along with it. all of these are combo's I do routinely and have done three different types of this combo in the last two weeks alone.
You show a severe weakness of abdominal wall by virtue of your extreme postural issues ( lordosis of the spine) , as well as skin excess and skin laxity. An abdominoplasty flank-pasty willl manage this well, but you need someone who shows this type of case in before and after results. Managing the extremely weakened abdominal wall requires experience, ingenuity, artistry, a good plan, proper execution, and good collaborative post op management. We do this all the time in my practice. Your breasts are wide, splayed laterally, and lack any projection. If you are happy, then leave them as is. But please do not do a simple implant augmentation. It is not the answer. You would be left with implant breast disassociation -an unhappy unaesthetic breast. Just wider and still saggy. You should have a lift and implant together or lift alone if anything. Best of luck attaining your goals!!
Patient priorities must be respected. An experience surgeon should be malleable of thought but not compromise the final results. Having said that, in this case, combining lipo and excisional brachyplasty ( arm lift) with breast lift with implants is a combination I do frequently. The second stage I would recommend would include total body lift and back lift. The back lift will join the breast lift scars seamlessly. Back lift is a poorly understood and under appreciated impactful procedure.
the experienced surgeon will guide the orchestration of procedures. Present technology does not allow for the safe reliable storage of fat for later use. The torso allows for more surgery to be done with safety than lower extremities. Generally speaking, Body lift combined with some aspect of breast surgery and hip liposuction and even buttock fat grafting can be combined together. This should always be done in a hospital with at least one night hospital stay. If there are reasons medically to do less in the first step, or a patient prioritizes arms over other areas, I generally do the tummy tuck first, and then completion body lift, hip lip, fat grafting of buttock, and arms secondarily. If arms are the number one priority and only require liposuction, they may be able to be done with the first tummy procedure. If arms require lipo and skin excision ( excisional brachioplasty), this should be separated form tummy tuck as the patient will need use of her arms to move about. So, you see, let an experienced surgeon guide the process.
This is where experienced surgeons are very important. The key here is not to compound subtle airway issues. I do a lot of combination surgeries. Sometimes when you put three surgeries together that are simple alone, they are still relatively simple when combined and the risk profile is not appreciably increased. On the other hand, certain surgeries don't mix and significantly increase risk. Rhinoplasty and Tummy tuck are two that don't mix well. Post tummy tuck the abdomen is tight and for some, breathing is somewhat restricted and harder for several days. Combining this with rhinoplasty will further compromise air exchange initially and can lead to otherwise avoidable complications such as atelectasis, fevers, or even pneumonia, dehydration, weakness other even more serious issues. So, I would strongly recommend separating these two.
